Individual
TRACY DENISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
688 WALNUT ST, SUITE 200, MACON, GA 31201-2677
(478) 742-7566
(478) 746-9944
Mailing address
5243 RIVERSIDE DR, APT 2105, MACON, GA 31210-8803
(478) 742-7566
(478) 746-9944
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004461
GA
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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